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Genital tuberculosis in infertile women: Assessment of endometrial TB PCR results with laparoscopic and hysteroscopic features

机译:不孕症妇女的生殖器结核病:对腹腔镜和宫腔镜特征的子宫内膜TB PCR的评估

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Objective Mycobacterial infections of the genital tract have been implicated in the etiology of female infertility. The correlation of endometrial TB PCR with laparoscopic and hysteroscopic features in patients with infertility was evaluated. Methods Women suffering from infertility and undergoing diagnostic laparoscopic and hysteroscopic examination were included. Endometrial specimens were assayed by Nested PCR for mycobacterium complex and the results were then retrospectively correlated with laparoscopic and hysteroscopic features. Results Positive TB PCR was observed in 32.18% (n=56) women. Out of these 56 patients, 48 had endoscopic abnormalities suggestive of tuberculosis (TB) and rest 8did not reveal any endoscopic abnormalities. However, of 174 patients 139 had endoscopic abnormalities with positive TB PCR in only 48. Sensitivity and specificity of endoscopic evaluation was 85.71 and 22.8%, respectively. The presence of periovarian adhesions, cornual block, tubal beading, tubercles, intrauterine adhesions, and ostial fibrosis had very strong association with positive TB PCR. Total predictive value of endoscopic evaluation in diagnosis of genital TB was 42.52%. Conclusion This study highlights that endoscopic evaluation is an important diagnostic tool, but can neither confirm nor exclude genital TB. Endometrial TB PCR may have to be routinely resorted to make a definite diagnosis of mycobacterial infection in endemic areas.
机译:目的在雌性不孕症的病因中涉及生殖道的分枝杆菌感染。评价子宫内膜TB PCR与不孕症患者腹腔镜和宫腔镜特征的相关性。方法包括患有不孕症和接受腹腔镜和宫腔镜检查的妇女。通过嵌套的PCR用于分枝杆菌复合物的巢式PCR测定子宫内膜标本,然后用腹腔镜和宫腔镜腔腔特征回顾结果。结果在32.18%(n = 56)妇女中观察到阳性Tb PCR。在这56名患者中,48例有内镜异常暗示结核病(TB)并休息8did未揭示任何内窥镜异常。然而,174例患者139名患者的内窥镜异常具有阳性TB PCR仅为48.内窥镜评估的敏感性和特异性分别为85.71和22.8%。难前的粘连,康隆块,输卵管串联,结节,宫内粘连和骨质纤维化的存在具有非常强烈的与阳性TB PCR相关。诊断生殖器结核病诊断中的内窥镜评估的总预测值为42.52%。结论本研究突出显示内窥镜评估是一个重要的诊断工具,但既不能确认也不能排除生殖器结核病。子宫内膜TB PCR可能必须常规采取措施在流行区域中的分枝杆菌感染明确诊断。

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